4.2.1 Ontological position
7KLVVWXG\VRXJKWWRH[SORUHWKHSDUWLFLSDQWV¶H[SHULHQFHVRIWKHSKHQRPHQRQ of ADHD and as such, subscribes to a relativist ontology. Willig (2008) defines a relativist ontology as one that µquestions the ³out-there-ness´ RI WKH ZRUOG
and it emphasises the diversity of interpretations that can be applied to it¶ (p. 13). This is in contrast to the realist approaches most commonly seen in the study of ADHD, and more widely, within medical categories associated with mental illness. A realist ontology sees the world as ordered and structured, with cause±effect relationships existing between these structures which can be measured and observed.
4.2.2 Epistemological position
Willig (2008) describes epistemological approaches within qualitative research as being positioned on a continuum from naïve realism (akin to positivism) to radical relativism. It is suggested that a range of positions fall within these extremes, which reflect the acceptance that knowledge and understanding of the world is affected to some degree by individuals interacting with the world (Willig, 2008). However, as Willig (2008) describes, researchers differ in their acceptance of the degree to which our understanding of the world can be objective and true (e.g. an absolute correct view).
As discussed in previous chapters, much of the research on ADHD has been within a positivist, empirical paradigm. This research has tended to focus on investigating the physical basis of ADHD (e.g. exploring neurological and genetic causality) and efficacy of drug treatment (Timimi and Radcliffe, 2004; Singh et al., 2010; Dunne and Moore, 2011). From this positivist position, reality is understood to be independent of human cognition, and it is believed that there is a single reality that can be researched through the application of scientific methodology. In contrast, I take the position that knowledge is a
social and historical product that can be specific to a particular time, culture or situation (Robson, 2002).
4.2.3 Methodological position
According to Yardley (1997), a primary reason for adopting qualitative PHWKRGRORJLHV LV µD UHFRJQLWLRQ WKDW RXU NQRZOHGJH DQd experience of the world cannot consist of an objective appraisal of some external reality, but is profoundly shaped by our subjective and cultural perspective, and by our FRQYHUVDWLRQV DQG DFWLYLWLHV¶ S 217). This research, in line with other qualitative studies, takes the view that the use of quantitative methods to explore ADHD has limitations in being able to capture adequately the quality and meaning of experiences of children and families who have ADHD in their lives (Hughes, 2007b; Gallichan and Curle, 2008). In contributing to this area of research, P\DLPKDVEHHQWRIRFXVRQFKLOGUHQ¶VDQGSDUHQWV¶VXEMHFWLYH experiential accounts of ADHD to explore personal meaning and lived experience; aV 5DIDORYLFK REVHUYHG SHRSOH µDVVHUW D WUHPHQGRXs DPRXQW RI DJHQF\ LQ KRZ WKH\ LQWHUSUHW WKH GLVRUGHU¶ S 6). It is qualitative research methods that enable researchers to delve into questions of meaning (Starks and Trinidad, 2007).
4.3. Qualitative approaches
Narrative therapists work to create alternative stories to the dominant GLVFRXUVHV WKDW FDQ EHFRPH µWRWDOLVLQJ GHVFULSWLRQV¶ RI SHRSOH¶V OLYHV ,Q DVVLVWLQJ SHRSOH WR µUH-DXWKRU¶ WKLFN GHVFULSWLRQV RI WKH µSUREOHP¶ WKH alternative story is explored to support people in engaging in the construction
and performance of preferred identities, leading to a thickened new plot (Winslade and Monk, 1999). In adopting a qualitative approach, my aim was to explore thick descriptive accounts of the phenomenon of ADHD. Qualitative methodologies, however, do noWSUHVHQWµDKRPRJHQRXVHQWLW\¶ 6PLWK , and there are a number of different approaches offering different theoretical and methodological perspectives. Despite these different perspectives, commonalities exist, as their central purpose is to enrich our understanding of the phenomena in question (Elliott et al., 1999). The qualitative approaches considered for this research study were narrative, discourse, grounded theory and phenomenology. A brief outline of each will be presented, prior to a brief account of my rationale for selecting the particular qualitative approach harnessed within this research study.
4.3.1 Narrative analysis
Narrative analysis provides the researcher with a means to understand how we make sense of the world and ourselves (Murray, 2015). Similarly to IPA, narrative researchers work with narrative accounts of particular experiences and are interested in meaning and understanding (Griffin and May, 2012). A narrative is an organised interpretation of a sequence of events in which the narrator organises the disorganised to give it meaning (Murray, 2015). A common theme in narrative research is the exploration of identity, with many narrative researchers interested in the social aspects of narrative (Griffin and May, 2012), rather than how the individual makes sense of their experiences. Like IPA, narrative analysis is interpretive, in that the researcher engages in
formulating meaning from the narrative; however, there is less structure in terms of how the analysis should proceed (Griffin and May, 2012).
4.3.2 Discourse analysis
'LVFRXUVH DQDO\VLV LV FRQFHUQHG ZLWK µKRZ LQGLYLGXDOV DFFRPSOLVK SHUVRQDO VRFLDODQGSROLWLFDOSURMHFWVWKURXJKODQJXDJH¶ 6WDUNV and Trinidad, 2007, p. 1374). There are two prominent versions of discourse analysis: discursive psychology and Foucauldian discourse analysis. Both share concern for the role of language in constructing social reality; however, they address different types of research questions (Willig, 2015). Discursive psychology studies how people use language, whereas Foucauldian discourse analysis is concerned with the ways in which discourse constructs subjectivity, self and power relations (Willig, 2008). Discursive representations are the unit of analysis in discourse analysis, whereas in IPA, the focus is on the individual and their meaning-making (Smith et al., 2009). Smith et al. (2009) argue that both YHUVLRQV RI GLVFRXUVH DQDO\VLV GHPRQVWUDWH µD VWURQJHU PRUH VLQJXODU FRPPLWPHQWWRVRFLDOFRQVWUXFWLRQLVP¶ S 195) than is the case for IPA.
Discourse analysts sample different groups who participate within a given GLVFRXUVH $ VWXG\ PD\ SUHVHQW D VLQJOH SHUVRQ¶V DFFRXQW RU XVH ODUJHU sample sizes to explore variations across persons and settings (Starks and Trinidad, 2007).
4.3.3 Grounded theory
Grounded theorists inquire about how social structures and processes influence how things are accomplished through a given set of social interactions (Starks and Trinidad, 2007). Like IPA, it is an inductive approach; however, the goal is to develop an explanatory theory from a range of participantV¶ H[SHULHQFHV ,Q VHHNLQJ WR H[SODLQ SDUWLFLSDQWV¶ SHUVSHFWLYHV LQ terms of wider social processes and their consequences, grounded theory does not have the same emphasis on analysis of individual experiences. :LOOLJ DUJXHV WKDW WKLV DSSURDFK WDNHV D YLHZ µIURP WKH RXWVLGH LQ¶ UDWKHUWKDQWKHµLQVLGHRXW¶YLHZWDNHQE\SKHQRPHQRORJLFDOUHVHDUFK S 45). Like phenomenology, the researcher engages in a self-reflexive process of recognising and setting aside prior knowledge and assumptions. However, the role of the researcher is viewed differently, depending upon the version of grounded theory, as each follows contrasting theories of knowledge (Sutcliffe, 2016).
Grounded theory uses theoretical sampling to recruit participants with differing experiences of the phenomenon in order to explore multiple dimensions of the social processes under study (Starks and Trinidad, 2007). The researcher continues to add individuals to the sample until saturation is reached; according to Starks and Trinidad (2007), typical grounded theory studies report sample sizes of between 10±60 participants.
4.3.4 Chosen methodological approach: phenomenology
3KHQRPHQRORJ\ LV µLQWHUHVWHG LQ WKH ZRUOG DV LW LV H[SHULHQFHG E\ KXPDQ EHLQJVZLWKLQSDUWLFXODUFRQWH[WVDQGDWSDUWLFXODUWLPHV¶ :LOOLJS The aim is to contribute a deeper understanding of lived experience (Starks and Trinidad, 2007): what it was like to live the experience, not just the SHUVRQ¶VUHDFWLRQWRLW 0XQKDOO
A number of approaches have been developed for phenomenological research: the descriptive and the interpretative (Willig, 2008). In seeking to describe the phenomenon under study, the former approach (e.g. Giorgi and Giorgi, 2008) requires the researcher to bracket their opinions and experiences about it (Reiners, 2012). The latter approach (e.g. IPA) focuses on interpretation and meaning rather than descriptions, and does not require the researcher to set aside their opinions and experiences (Reiners, 2012).
In both approaches, purposive sampling methods are used to recruit participants who have experienced the phenomenon under study (Starks and Trinidad, 2007); samples can range from 1 to 10.
Phenomenology has been described as a philosophical approach to the study of experience (Smith et al., 2009). As such, I believed this to be the most appropriate theoretical approach to explore the lived experience of ADHD from the perspectives of both children who have received a diagnosis of the disorder and their parents. As discussed, a number of approaches have been GHYHORSHG IRU SKHQRPHQRORJLFDO UHVHDUFK µDOO VKDUH WKH EDVLF WHQHW RI
phenomenology but each articulates an DSSURDFKLQDSDUWLFXODUZD\¶ 6PLWK
et al., 2009, p. 200). Interpretative phenomenological analysis (IPA) was
selected for this research study, my reasons for which are discussed below.